Related Experiment Video
Updated: Jun 26, 2025
Author Spotlight: Integrating Tai Chi with Mindfulness Training to Achieve an Effective Mind-Body Exercise
Published on: July 14, 2023
Prevalence and Risk Factors of Distal Symmetric Polyneuropathy Among Predominantly Non-Hispanic Black, Low-Income
Melissa A Elafros1, Alexanndra Brown1, Huda Marcus1
1From the Departments of Neurology (M.A.E., A.B., E.L.F., B.C.C.) and Biostatistics (M.B.), University of Michigan, Ann Arbor; Department of Internal Medicine (H.M., T.D., G.I.B.), Hurley Medical Center, Flint, MI; Department of Medicine (H.M., T.D., G.I.B.), Michigan State University, East Lansing; Department of International Health (P.J.W.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Neurology (M.K.), University of Rochester, NY; Department of Internal Medicine (M.K.), University of Zambia, Lusaka; and Department of Neurology (L.E.S.), Northwestern University, Chicago, IL.
Background And Objectives:
Distal symmetric polyneuropathy (DSP) is a disabling, often painful condition associated with falls and reduced quality of life. Non-Hispanic Black people and people with low income are underrepresented in existing DSP studies; therefore, it is unknown whether data accurately reflect the prevalence, risk factors, and burden of disease in these populations.
Methods:
Patients older than 40 years presenting to an outpatient internal medicine clinic predominantly serving Medicaid patients in Flint, Michigan, were enrolled in a cross-sectional study. Demographics, clinical characteristics, including medication use, anthropomorphic measurements, fasting lipids, and hemoglobin A1c were collected. DSP was defined using the modified Toronto Clinical Neuropathy Score (mTCNS). Multivariable logistic regression was performed to model DSP and undiagnosed DSP as a function of potential risk factors age, metabolic syndrome, and race. DSP burden was measured using Peripheral Neuropathy Quality of Life Instrument-97.
Results:
Two hundred participants were enrolled, and 169 (85%) completed all data collection. The population was 55% female of mean age (SD) 58.2 years (10.4) and 69% non-Hispanic Black. Among the population, 50% had diabetes, 67% had metabolic syndrome, and 47% had a household income <$20,000. DSP was present in 73% of the population, of which 75% were previously undiagnosed. Neuropathic pain was documented in 57% of participants with DSP. DSP based on mTCNS criteria was associated with older age (odds ratio [OR] 1.1 [95% confidence interval (CI) 1.03-1.2]) and metabolic syndrome (OR 4.4 [1.1-18.1]). Non-Hispanic Black participants had lower odds of DSP (OR 0.1 [0.01-0.4]) than non-Hispanic White and Hispanic participants. DSP burden was high, including increased pain, health-related worry, and poorer quality of life (all p < 0.001).
Discussion:
DSP is extremely common and often underrecognized in this predominantly non-Hispanic Black, low-income population and leads to substantial disease burden. Metabolic syndrome is a highly prevalent, modifiable risk factor in this population that should be managed to lower DSP prevalence.
More Related Videos
Related Concept Videos
01:15Diabetes: Symptoms, Diagnosis, and Complications
01:18Disorders of the Autonomic Nervous System
Raynaud's disease, also known as Raynaud's...